Clinical Psychology Commons^™

Boundaries Of Belonging: The Role Of Christian Campus Climate In Lgbtq+ Student Suicidality, Madison L. Vaccaro

Clinical Psychology Dissertations

LGBTQ+ students at religiously-affiliated colleges experience unique stressors related to discrimination, campus climate, and stigma, which have been linked to negative outcomes including suicidal ideation. Drawing on sociocultural theories of suicide and minority stress, the present study examined whether internalized LGBTQ+ related stigma mediated the relationships between discrimination, negative campus climate, and suicidal ideation among college students attending religious institutions. Participants (N = 75) included college students who identified as LGBTQ+, recruited mainly within the Pacific Northwest. Participants were majority White, assigned female at birth (AFAB), and diverse in gender identity and sexual orientation. Measures assessed experiences of discrimination, campus …

Investigating The Moderating Roles Of Adolescent Peer Relationship Difficulties And Prosocial Behavior On The Relationship Between Triangulation And Adolescent Emotional Symptoms During Parental Divorce, Taylor Kalei Demotta

Clinical Psychology Dissertations

The divorce process is a stressful, transitional period that is widely experienced by families in the United States. This process incites a variety of stressors and deleterious family dynamics that impact children and adolescents. The divorce literature has identified parental conflict as a significant contributor to youth outcomes following divorce. Therefore, researchers have aimed to investigate the specific dynamics occurring during interparental discord that may influence youth. Triangulation, or the involvement of children in parental disagreements, has been found to mediate the relationship between parental conflict and adolescents’ internalizing symptoms. Adolescents may be particularly vulnerable to triangulation due to increases …

Mixed-Methods Evaluation Of A Therapeutic Assessment Clinic Model For Children With Prenatal Alcohol And Substance Exposures, Lauren Perovsek

Clinical Psychology Dissertations

Prenatal alcohol and/or substance exposure (PA/SE) affects an estimated 6% to 23% of the U.S. population and is associated with complex neurodevelopmental profiles impacting cognitive, adaptive, and behavioral domains. Children with PA/SE frequently experience co-occurring early adversity, face significant diagnostic complexity, and encounter challenging systems of care. This often leads to individuals with PA/SE and their caregivers navigating substantial barriers to care, including stigmatizing experiences and fragmented service systems. The Specialized Neurodevelopmental Assessment and Consultation Service (SNACS) clinic addresses these needs through an FASD-informed model that integrates therapeutic assessment techniques within a brief, multi-session evaluation process. While prior research has …

Nutrition, Physical Activity, Faith, And C-Reactive Protein As Predictors Of Depression In A Large Prospective Sample, Rebecca L. Banning

Clinical Psychology Dissertations

Depression is an increasingly common mental health concern and has been linked to both lifestyle factors and biological markers of inflammation. This study examined whether physical activity, dietary patterns, and religiosity/spirituality (R/S) predicted depression symptoms through their associations with high-sensitivity C-reactive protein (hs-CRP), a widely used biomarker of inflammation. Using data from the National Longitudinal Study of Adolescent to Adult Health, participants were assessed at Wave II (ages 12–20) and Wave IV (ages 24–32). Predictors included self-reported physical activity, proinflammatory and anti-inflammatory diet composites, and R/S engagement. Outcomes included concurrent and prospective depression symptoms, as well as hs-CRP concentrations. Results …

Relation Between Executive Functions, Ruminative Thinking Style, And Internalizing Symptoms In Neurodivergent Individuals., John Strom

Clinical Psychology Dissertations

Introduction: Neurodevelopmental disorders (NDD) are among the most common psychological disorders occurring in childhood (Bishop, 2010; Scandurra et al., 2019), and are commonly associated with a host of psychological challenges including deficits in executive functioning (Craig et al., 2016; Demetriou et al., 2019) as well as comorbid internalizing disorders such as depression and anxiety (Katzman et al., 2017; Kirsch et al., 2020; Simonoff et al., 2008). Research has suggested that executive function deficits may contribute to symptoms of depression and anxiety and that this relation may be mediated by ruminative thinking styles (Snyder et al., 2019; von Hippel et al., …

Invisible Intersections: Race, Adhd, And The Role Of Disciplinary Actions In Academic Outcomes, Miles Feller

Clinical Psychology Dissertations

Race is a marginalized identity linked to significant achievement gaps for Black and Latino students in the USA (de Bray et al., 2019). These students experience higher rates of exclusionary school discipline (ESD) than White and Asian peers (Aud et al., 2010; de Bray et al., 2019), with suspensions correlating to lower academic performance (Del Toro & Wang, 2022; Wang et al., 2023; Owens & Hinshaw, 2016). Additionally, developmental disabilities like ADHD intersect with these issues; despite narrowing racial disparities in diagnoses (Cénat et al., 2022; Fairman et al., 2020), access to treatment remains uneven (Baglivio et al., 2017; Coker …

Impact Of Perceived Stress And Trait Resilience On Mental Health Outcomes Related To Traumatic Stress Exposure, Ken Safley

Clinical Psychology Dissertations

Traumatic stress exposure is common and associated with a range of adverse psychological outcomes, including anxiety, depression, and posttraumatic stress disorder (PTSD). These effects are cumulative, with increased exposure linked to greater psychological distress. However, there is considerable variability in how individuals respond to trauma, suggesting the influence of cognitive and dispositional factors. Cognitive models of PTSD highlight the role of stressor appraisals in the development of psychopathology, while individual differences in protective factors, such as trait resilience, may buffer these effects. The present study investigated whether perceived stress mediates the relationship between trauma exposure and psychological outcomes, and whether …

The Potential Mediating Role Of Perfectionistic Self-Presentation In The Relationship Between Other Stigma, Self-Stigma, And Attitudes Towards Mental Health Help-Seeking In Asian Americans, Trevor E. Taone

Clinical Psychology Dissertations

The importance of understanding why individuals decided to engage in mental health care cannot be overstated. This importance is further highlighted in the need to examine the different factors that may help researchers and clinicians to obtain more insight into why populations with a higher demand for mental health services, such as Asian Americans, possess negative attitudes toward seeking mental health care. Stigma has been identified as a significant barrier that influences these attitudes towards help-seeking. Other stigma and self-stigma, in particular, play an important role in understanding why individuals may possess negative views about mental health care help-seeking. With …

Longitudinal Relations Between Self-Esteem And Depression: A Continuous Time Analysis With Exploration Of Sleep Duration Effects, Mackenzie Cummings

Clinical Psychology Dissertations

Adolescents and young adults face elevated risk for depression. While poor self-esteem and sleep disturbance are known risk factors, few studies have examined their unique and interactive contributions. Longitudinal research often overlooks unequal intervals and multiple sources of variance (e.g., between- and within-person). This study used continuous time structural equation modeling to address these gaps and examine relationships between self-esteem, sleep duration, and depression from adolescence into adulthood. Drawing on four waves of data from the National Longitudinal Study of Adolescent to Adult Health (N = 6,184), I tested whether sleep duration moderated the self-esteem–depression link and explored gender differences. …

Inhibitory Control: A Mediator Between Sensory Responsivity And Externalizing Behaviors In Children On The Autism Spectrum, Kaitlyn M. Drafton

Clinical Psychology Dissertations

Sensory differences are among the most commonly reported symptoms in children on the autism spectrum and have been linked to both externalizing behaviors and executive functioning challenges. However, few studies have explored the potential mechanisms that underlie these relationships. The present study examined whether inhibitory control mediates the relationship between sensory responsivity and externalizing behaviors in young autistic children, each rated via caregiver-report measures. Participants included 107 caregivers of autistic children between the ages of 5-10 years old. It was hypothesized that higher levels of sensory responsivity would predict greater difficulty with inhibition, which in turn would be associated with …

The Role Of Gender And Sexual Identity In Mental Health Outcomes For Asylum-Seeking Survivors Of Sexual Torture, Samantha A. M. Doerr

Clinical Psychology Dissertations

Millions of people worldwide flee violent persecution each year, with more than 6.8 million estimated to have sought asylum in 2023 alone (United Nations High Commission on Refugees, 2025). Up to 40% of refugees and asylum-seekers are reported to be survivors of torture, with sexual torture one of the most commonly-reported means of torture, particularly among women and LGBTQ+ populations (Abu Suhaiban, 2019; Hopkinson et al., 2017; United Nations High Commission on Refugees, 2017). Sexual torture has been associated with severe impacts on mental health, including posttraumatic and depressive symptoms. Despite marked differences in sexual torture risk across gender and …

Functional And Cultural Values Of Shame: A Motivator To Seek Help For Suicidal Ideation, Yu-Chin Lin

Clinical Psychology Dissertations

Suicide is a global issue with rates continuing to rise despite decades of research and prevention efforts. The role of shame in the development of suicidal ideation, especially within non-Western contexts, remains underexplored. This mixed-methods study explored the relationships among shame, suicidal ideation, and help-seeking intentions in a Taiwanese sample, focusing on four culturally distinct Mandarin terms for shame—diu lian, can kui, xiu kui, and xiu chi. A total of 101 participants who has experiences of suicide-related thoughts or behaviors responded to an online survey. Quantitative analyses revealed that all shame terms were strongly correlated …

Legal Advocates As Lifelines: Initial Psychometric Evaluation Of Victim Rights Within A Community-Based Agency, Jaylee York

Clinical Psychology Dissertations

Navigating the legal process after sexual violence is often distressing and poses a risk of secondary victimization (Campbell, 2013). Victim Bill of Rights legislation throughout the U.S. aims to establish legal protections for victims. Organizations such as the King County Sexual Assault Resource Center (KCSARC) offer independent legal advocacy. This dissertation sought to engage in socially responsive research with KCSARC to better understand the needs of both the organization and the survivors they serve.

This study developed and psychometrically evaluated two new measures: Victim Rights to Process (VRP), assessing whether a victim feels their rights to the legal process have …

Booked Or Buried In Texas: Risk Factors For Prebooking Suicide And Homicide Deaths Of Individuals With Sex Offenses, Nicole Moreira

Clinical Psychology Dissertations

Preventable deaths during law enforcement encounters, particularly those violent in nature, such as suicide and homicide deaths, are of considerable public concern. Prebooking, the law enforcement custody stage that includes arrest, serving warrants, wellness checks, traffic stops is often the most dangerous and fatal stage of custody. Despite being the most potentially dangerous and unpredictable of any custody stage, prebooking remains grossly understudied in comparison to jail and prison research, underscoring the need for focused research. To address this gap, the present study examines risk factors for suicide and homicide deaths among individuals with sex-related offenses during prebooking custody. Individuals …

The Role Of Somatization In Predicting Health-Related Quality Of Life Among Racial And Ethnic Minorities: Examining The Mediating Effects Of Perceived Injustice And Symptom Catastrophizing, Kimi Han Hashimoto

Clinical Psychology Dissertations

There is a pressing need to address the significant health disparities of underrepresented groups such as racial and ethnic minorities (Mills et al., 2020). As of 2019, individuals identifying as a racial or ethnic minority make up 40% of the U.S population as of 2019, yet they fare significantly worse across many health-related measures (Hill et al., 2022). Given these disparities in healthcare and health outcomes, racial and ethnic minorities represent an important group to investigate somatization and health-related quality of life (HRQOL). Cognitive appraisals, such as perceived injustice and symptom catastrophizing, may mediate this relationship, influencing how somatization translates …

“I Will Never Be Out With This Campus”: Impacts Of Lgbtq+ Microaggressions, Clara E. O'Brien

Clinical Psychology Dissertations

This study reports on the results of a mixed method analysis on the experiences of LGBTQIA+ microaggressions experienced at a non-affirming Free Methodist affiliated university campus. The impact of religiously based LGBTQIA+ microaggressions on religion-sexuality conflict and, in turn strength of religious faith and sexual identity distress was examined. Further, I explored whether racial identity moderated the relationship between religiously based LGBTQIA+ microaggressions and sexual identity distress. Participants (N = 248) included students, faculty, and staff identifying as LGBTQIA+. Quantitative results suggested that that greater religion-sexuality conflict was associated with greater strength of religious faith (B = .239, …

Examining Cognitive Functioning And Digital Technology Engagement, Kylie Fraga

Clinical Psychology Dissertations

Using technology to complete instrumental activities of daily living (T-IADLs) reflects adaptive technology use, while absentminded smartphone use (AMSU) reflects maladaptive technology use. Examining the link between cognitive functioning and distinct forms of technology use can inform clinical strategies for optimizing technology use for individuals with cognitive difficulties and assist in digital design recommendations that align with diverse cognitive needs. This study examined associations between cognitive functioning (objective and subjective) and distinct forms of technology behaviors (T-IADLs and AMSU) within a sample of 93 adults (Mage = 52.6, SD = 16.93; 62% female) recruited from neuropsychology private practice clinics in …

Factor Analysis Of Neuropsychological Attention Measures With Mild Traumatic Brain Injury Patients, Elizabeth Mateer

Clinical Psychology Dissertations

This study explored the factor structure of commonly used neuropsychological tests to assess attention in individuals with mild traumatic brain injury (mTBI). The study aimed to clarify the relationships among tests traditionally used to assess different components of attention, including the NAB Numbers & Letters Test, Paced Auditory Serial Addition Task (PASAT), Trail Making Test A & B, Digit Span, Arithmetic, and Coding. Exploratory factor analysis (EFA) with an oblimin rotation procedure was used to identify the factor structure. The EFA suggested that a four-factor solution was optimal. These factors were identified as: (1) visual attention and psychomotor speed, (2) …

Interpersonal Theory Of Suicide In A Mild Traumatic Brain Injury Sample, Janelle Wee

Clinical Psychology Dissertations

Mild traumatic brain injury (mTBI) is associated with cognitive and emotional changes that may increase suicide risk. This study, grounded in the Interpersonal Theory of Suicide (IPTS), examined whether premorbid functioning moderates the relationship between cognitive functioning (working memory and processing speed) and suicidal desire (thwarted belongingness and perceived burdensomeness) in individuals with mTBI. Participants (n = 54) were drawn from a clinical neuropsychological sample and completed the WAIS-IV, TOPF, BDI-II, and Interpersonal Needs Questionnaire (INQ). Hierarchical moderated regression analyses were conducted across 100 multiply imputed datasets. Depressive symptoms were included as a covariate. Results showed that depressive symptoms …

Social Support Networks’ Influence On First-Generation Professionals’ Career Success, Melissa-Ann M. Lagunas

Clinical Psychology Dissertations

This dissertation examines how perceived social support influences career success among first-generation professionals (FGPs)—individuals who are first in their families to pursue white- collar careers. Drawing on Seibert et al.'s (2001) Social Capital Theory of Career Success, I investigate direct and indirect pathways through which social support affects three dimensions of career success: sense of belonging, professional flourishing, and career satisfaction, while exploring mediating roles of perceived support network quality and resilience. A sample of 230 FGPs (Mage = 31.9 years, SD = 5.32) completed a 62-item online survey hosted on Qualtrics. Participants represented diverse professional disciplines classified into five …

The Impact Of Coping Strategies On The Perceived Stress And Well-Being Of People With Disabilities During The Covid-19 Pandemic, Angela G. Maccarrone

Clinical Psychology Dissertations

The COVID-19 pandemic significantly and negatively impacted those around the world, particularly marginalized groups such as people with disabilities (PWDs). What remains unclear from existing published research is the exact relationship between perceived stress of the pandemic, coping, and overall well-being in PWDs. Prior research and theoretical models of coping suggest that active coping processes are associated with more positive outcomes versus avoidant coping strategies, which have shown less favorable outcomes on well-being. Due to the varying ways in which the pandemic affected PWDs, coping might serve as a moderator, amplifying the negative relationship between perceived stress and well-being. Building …

Inevitable Or Preventable? A Pilot Intervention To Reduce Burnout Risk In Acute Care Nurses, Emily R. Kelly

Clinical Psychology Dissertations

Purpose: Burnout among healthcare workers is widespread and costly, resulting in calls for action to reduce the experience and impact of this work-related phenomenon. Burnout among nurses has been associated with impaired patient safety, decreased quality of care, lower levels of patient satisfaction, decreased productivity, and higher levels of intent-to-leave the profession. Aim: The aims of this study are to assess whether sleep problems mediate the relationship between recovery and burnout and to examine the feasibility of a pilot intervention to enhance recovery, improve sleep quality, and reduce burnout among inpatient nurses. Method: Eligible participants included registered nurses who worked …

Predicting Changes In Accommodation Throughout Pediatric Intensive Outpatient Cognitive Behavioral Therapy For Obsessive-Compulsive Disorder, Rachel S. Inabata

Clinical Psychology Dissertations

Family systems play an integral role in the development and maintenance of mental health disorders. In the context of pediatric obsessive-compulsive disorder (OCD), accommodation is a common interpersonal phenomenon in which families may unwittingly reinforce symptoms and avoidance behavior of the patient. Treatments for severe pediatric OCD such as intensive outpatient programs (IOP) often involve family to reduce accommodation. Little research has investigated baseline symptoms as predictors of change in accommodation in IOP contexts serving patients with high-acuity OCD. The current study examined the role of baseline OCD, anxiety, depression, and functional impairment in changes in accommodation throughout OCD treatment …

Pain Beneath The Surface: Emotional Self-Control & Trauma In Central Sensitization Among Asian Americans, Yasmin Banga, Lisette Thurlkill, Munyi Shea

School of Psychology, Family, and Community Research Conference

Research has established the links between trauma exposure, PTSD symptoms, and central sensitization. Yet, few studies have specifically examined this mechanism in Asian Americans with chronic pain. This study aims to examine how culture-specific factors, such as emotional self-control, as well as underlying PTSD symptoms play a role in this mechanism among Asian American adults. A sample of 160 Asian Americans with chronic pain was surveyed. Results suggest that PTSD symptoms significantly mediated the impact of trauma exposure on central sensitization, whereas emotional self-control was a non-significant mediator or moderator. Study limitations and implications will be further discussed.

Employment Role Change And Resilient Coping On Affective Well-Being During The Covid-19 Pandemic, Hatun Almuhanna, Penelope Seminario, Lynette Bikos

School of Psychology, Family, and Community Research Conference

The purpose of our study was to evaluate the effect of employment related role change directly upon affective well-being and indirectly through resilient coping in the first year-and-a-half of the COVID-19 pandemic. Participants (N = 197; age M=48.85, SD = 15.28) completed up to 24 waves. Results suggested that the direct effect of role change on affective well-being was statistically significant (B = 0.037, p < 0.024). Although there was a significant effect of resilient coping on affective well-being (B = 0.227, p < 0.001), the indirect effect passing from employment role change through resilience coping to affective well-being was not (B = 0.002, 95CI -0.006, 0.010, p 0.574). The results speak to the centrality of the employment role.

Defining Healthy Love: A Narrative Review Of Purity Culture's Impact On Healing From Sexual Assault, Gloria L. Diehl

Honors Projects

Over the last few decades, evangelical Christian teachings on sexuality have become an area of increasing interest as those who grew up in Purity Culture experience long-term effects on their world-concept. One area where the effects are particularly potent is attitudes regarding sexual assault. Research on healing from sexual assault identifies social responses to reports as a defining factor for the direction of healing. This literature review looks at how social support is negatively impacted by purity culture teachings through the endorsement of rape myth acceptance and victim blaming attitudes.

The Survivability Hierarchy Behind Bars: Themes, Reforms, And Prevention Program Evaluations In Washington State Jail Suicides, Rocky B. Marks

Clinical Psychology Dissertations

Across jails nationwide, suicide remains the leading cause of death. Suicide has been the leading cause of death for U.S. jail inmates for over 40 years. In Washington State, suicide accounts for 47% of all jail fatalities while incarcerated. To address this critical issue, the U.S. Justice Department set best practices for jails to follow for suicide prevention programs in 1989. Yet, these best practices have not reduced the disproportionate rate of jail suicides. Far from a decrease, suicide deaths for jail inmates rose 13% in the last 20 years. This dissertation involved three methods of analysis for this critical …

Moderating Effect Of Secondary Victimization On The Relationship Between Resilience And Sexual Assault Coping Self-Efficacy, Jamie Layton

Clinical Psychology Dissertations

Sexual assault is a prevalent public health concern that effects thousands of people every year. How each of these individuals responds is different. There are multiple factors that can impact someone’s response to sexual assault, one of which is resilience, and another is secondary victimization. Legal advocacy programs can be used to help reduce secondary victimization and increase sexual assault coping self-efficacy, while controlling for age and race. This dissertation examines the way that secondary victimization moderates the relationship between resilience and sexual assault coping self-efficacy. Participants were at least 18 years old, a cisgender woman, English speaking, and a …

Examining The Effects Of Social Group Persecution And Traumatic Humiliation In Survivors Of Torture, Tilda Cvrkel

Clinical Psychology Dissertations

Refugees and asylum seekers account for 34.4 million people worldwide (UNHCR, 2021), and up to 40% of this population are survivors of torture (UNHCR, 2017). The Istanbul Protocol (United Nations, 2022) describes one of the explicit ends of torture as the severing of a person from their community, a breaking of their dignity and humanity. This may be done explicitly, through acts of traumatic humiliation. Traumatic humiliation includes acts such as forcing victims to eat religiously forbidden food, forced posing or touching others in culturally taboo sexual ways, forced nudity or clothing that reflects misgendering (such as “emasculating” clothing), widespread …

Suicidal Ideation And Community Connectedness In Lgbtq+ Adults: Can Emotion Regulation And Mindfulness Skills Help?, Samantha V. Jacobson

Clinical Psychology Dissertations

Suicidal ideation disproportionally affects the LGBTQ+ community. Community connectedness and mindfulness can be protective against suicidal ideation, whereas emotion regulation difficulty is associated with increased suicidal ideation. Community connectedness, emotion regulation difficulty and mindfulness have demonstrated relationships to each other in the LGBTQ+ community and while they are each independently associated with suicidal ideation, their combined impact on suicidal ideation has not yet been examined. The present study examines moderating effects of emotion regulation difficulty and mindfulness on the relationship between community connectedness and suicidal ideation in LGBTQ+ adults. 141 LGBTQ+ adults completed self-report measures of suicidal ideation, community connectedness, …